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Ethosuximide in the treatment of absence (petit mal) seizures

Departments of Neurology, University of Virginia School of Medicine, Charlottesville; the Medical College of Wisconsin, Milwaukee; and the Section on Epilepsy, Applied Neurologic Research Branch, Collaborative and Field Research, National Institute of Neurological Diseases and Stroke, Bethesda.

Thirty-seven patients with previously untreated absence seizures were treated with ethosuximide. Seizures were completely controlled in 7 patients (19 percent); 90 to 100 percent control was achieved in 18 patients (49 percent) and 50 to 100 percent control in 35 (95 percent). Plasma ethosuximide concentration increased with dose, but variability in the plasma concentration produced by a given ethosuximide dose made it impossible to predict a patient's plasma concentration from the dose. The therapeutic range of plasma ethosuximide concentration was 40 to 100 µ-g per milliliter. Patients with evidence of structural central nervous system abnormalities responded as well or better to the drug as patients without such evidence. Ethosuximide did not impair psychometric performance, but rather resulted in improved performance in 17 cases. The side effects of ethosuximide were minor, and rarely required withdrawal of the drug.

This paper was read in part at the twenty-fourth annual meeting of the American Academy of Neurology, St. Louis, April 1972.

Supported in part by NINDS contracts NIH-69–2196 and NIH-69–2169, and by grants RR-304 and RR-00058 from the General Clinical Research Centers Program of the Division of Research Resources, National Institutes of Health.

Received for publication July 11, 1974.

Dr. Penry's address is Federal Building, Room 114, National Institutes of Health, Bethesda, MD 20014.

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